It is possible for car registration and insurance to be in different names in most US states. This is because the car's owner can be an approved driver on the policy, rather than the primary policyholder. However, having different names for car registration and insurance may result in misunderstandings and confusion on the insurer's side, which could lead to higher settlement payments. It's important to note that some states still prohibit having different names for insurance and registration. It is recommended to check with the relevant state authorities to confirm their specific requirements.